Claim total
$1,176.48
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1962-06-22
- Stop
- 1962-06-22
The parties
- Patient
- patient Justine Walter Sanford
- Provider
- provider Julene Lemke
- Payer
- payer UnitedHealthcare
Record id
22af1154-23c4-5080-6469-f7f7b569fc69